Is that $100,000 hepatitis treatment worth the price? Yes, but can society afford it?

New research shows that the high price tag of new hepatitis C medications does pay off in terms of savings down the road, of keeping patients healthier in the long run.

The stratospheric prices of new drugs are sometimes rationalized by the savings they’ll generate down the road — cure a condition now, even at high expense, and you’ll reap the benefits by keeping the patients in better health and off the operating table.

A team of researchers from UC San Francisco and the Institute for Clinical and Economic Review, a nonprofit research organization in Boston, has subjected the new crop of hepatitis C drugs to just such a real-world calculation. According to their findings, published in the journal JAMA Internal Medicine, the drugs, which can cost nearly $100,000 for a 12-week cure, pass the test — they’re priced reasonably in terms of their cost per added year of life and good health for almost all patients.

But that just sharpens the debate on drug prices. A drug can be cost-effective, yet unaffordable. Many are so expensive that despite their benefits for patients, in the aggregate, they’re budget-busters for government programs or insurance carriers. As a result, many patients who would gain those additional healthy years may not gain access to treatment at all.

The new hepatitis C treatments include two from Gilead Sciences: Sovaldi, which costs $84,000 per 12-week treatment, and Harvoni, which was priced at nearly $100,000 when it was introduced about a year ago. Both drugs have become symbols of out-of-control pharmaceutical prices. But they’re also extremely effective at curing the infection, with minimal side effects.

“This is an incredibly effective treatment,” says Jeffrey A. Tice, a member of the UC San Francisco team that studied the drugs’ cost in conjunction with the Institute for Clinical and Economic Review. “By the usual metric, it’s cost effective. But the problem is that there are so many people who are infected, that it breaks the bank of a healthcare organization to treat a substantial percentage of patients in any one year.”

At current list prices, the study found, the treatment of 100% of America’s more than 2 million hepatitis C sufferers could cost more than $100 billion over five years, even after accounting for offsetting gains reaped from avoiding medical problems caused by untreated infection.

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